Joint Australian Diabetes Society/Australian and New Zealand Society of Nuclear Medicine procedure guideline for FDG PET / CT imaging in patients with type 1 and type 2 diabetes

¹⁸F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) is an established imaging technique for tumour diagnosis and staging, with imaging quality in people with diabetes closely linked to blood glucose concentration at the time of FDG injection. Adequate preparation is crucial for precise interpretation of PET/CT findings. However, protocols vary among institutions due to the availability of resources and expertise. This article summarises and provides commentary on a recently published de novo guideline, jointly endorsed by the Australian Diabetes Society and the Australian and New Zealand Society of Nuclear Medicine, which provides practical guidance for nuclear medicine staff managing people with type 1 and type 2 diabetes undergoing FDG PET/CT imaging. Recommendations were developed using an evidence-based approach informed by a comprehensive literature review and refined by a multidisciplinary expert panel. The guidelines outline standardised preparation protocols tailored to diabetes type, including advice on fasting, oral glucose-lowering medications, insulin regimens and insulin pump management. Adoption of these recommendations aims to optimise FDG PET/CT image quality while prioritising patient safety and improving FDG PET/CT scan quality for individuals with diabetes.